The study aimed at postoperative antibiotics or PA is often administered to patients after instrumented spinal surgery until all drains are removed to prevent surgical site infections (SSI). This practice is discouraged by numerous medical society guidelines, so our institutional Neurosurgery Quality Improvement Committee decided to discontinue the PA use for this population. We retrospectively reviewed data for patients who had instrumented spinal surgery at our institution for seven months before and after this policy change and compared the frequency of SSI and development of antibiotic-related complications in patients who received PA to those who did not (non-PA).
The doctors identified 188 postoperative antibiotics patients and 158 non-PA patients. Discontinuation of PA did not increase the SSI frequency. The growth of resistant bacteria did not significantly reduce in the non-PA period than the PA period. The cost of antibiotics for PA patients was $5,499.62, whereas antibiotics for non-PA patients were $0. On a per-patient basis, the cost associated with antibiotics and resistant infections was significantly greater for patients who received PA than those who did not. Therefore the study showed that patients in this population do not need PA, and the treatment can reduce the complications if PA is withheld